Improving pediatric cancer care disparities across the United States-Mexico border: Lessons learned from a transcultural partnership between San Diego and Tijuana

• Main Authors: Paula eAristizabal, Spencer eFuller, Rebeca eRivera, David eBeyda, Raul Correa Ribeiro, William eRoberts
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2015-06-01
• Series: Frontiers in Public Health
• Subjects: pediatric cancer; global health; border health; Health systems strengthening; US-Mexico border; International Oncology
• Online Access: http://journal.frontiersin.org/Journal/10.3389/fpubh.2015.00159/full

In 2007, the five-year survival rate for children with acute leukemia in Baja California, Mexico was estimated at 10% (vs. 88% in the United States). In response, stakeholders at St. Jude Children’s Research Hospital, Rady Children’s Hospital San Diego and the Hospital General de Tijuana implemented a transcultural partnership to establish a pediatric oncology program. The aim was to improve clinical outcomes and overall survival for children in Baja California. An initial needs assessment evaluation was performed and a culturally-sensitive, comprehensive, five-year plan was designed and implemented. After six years, healthcare system accomplishments include the establishment of a fully functional pediatric oncology unit with 60 new healthcare providers (vs. 5 in 2007). Patient outcome improvements include a rise in five-year survival for leukemia from 10% to 43%, a rise in new cases diagnosed per year from 21 to 70, a reduction in the treatment abandonment rate from 10% to 2%, and a 45% decrease in the infection rate. More than 600 patients have benefited from this program. Knowledge sharing has taken place between teams at the Hospital General de Tijuana and Rady Children's Hospital San Diego. Further, one of the most significant outcomes is that the Hospital General de Tijuana has transitioned into a regional referral center and now mentors other hospitals in Mexico. Our results show that collaborative initiatives that implement long-term partnerships along the United States-Mexico border can effectively build local capacity and reduce the survival gap between children with cancer in the two nations. Long-term collaborative partnerships should be encouraged across other disciplines in medicine to further reduce health disparities across the United States-Mexico border.